I still remember the first time I was ever observed doing a sight test in full. In fact, it still lives large in my memory. It was 1999 and it was the first examined assessment in the first semester of my second year. Being 1999, my choice of tie was questionable, at best, and my mother would not have been proud of the ironing of my shirt.
My observer, Dr Matthew Simunovic (now a vitreoretinal surgeon in Sydney), probably wasn’t too proud of my fledgling optometric abilities either, but he kept that to himself. On the day, he was the epitome of fairness; supportive, empathetic and balanced. He gave (mainly) positive feedback and lots of encouragement.
In our profession, we are perhaps conditioned to regard observation of any interaction we carry out as a form of assessment since our exposure to this format is usually within an OSCE (Objective Structured Clinical Examination) or other summative assessment.
While we are not by any means an island in this regard, we are certainly outliers. In nearly all registered professions, there is a widespread culture, and in many cases a requirement, of holding regular peer observations, which form a key part of CPD (Continuing Professional Development) and reflective practice. Indeed, colleagues who work with ophthalmology or allied health professionals will be very familiar with this concept.
I wonder how long it has been since a peer observed you carrying out a clinical examination or part of your professional practice? I wonder how many habits have crept in; good, bad and indifferent? I wonder how many things we do just because ‘we’ve always done it like that’, or because we were shown that way in our pre-registration or scheme for registration period?
What is stopping you from starting this in your practice with your colleagues? The incentives to do so have never been higher, especially since you could log it as a piece of self-directed CPD by providing a short, reflective statement. You could support another colleague by enabling them on this brave step into what, for many, is the unknown. The patients you ask to be a part of these observations will be unlikely to mind, however, consent is needed. But it needn’t take huge volumes of time to observe, discuss and reflect before reciprocating with a colleague. To me, it seems that the barrier is just the will to make that step by getting over that apprehension and, maybe, plucking up the courage to ask your colleague.
In most other disciplines there is encouragement for different observation partners over time to enable the best outcomes, in terms of widening the benefits and exposure of practice. It could be you in your practice who is the catalyst for leading this change, and it would be a positive one.
The outcomes can be quite transformative, as it encourages best practice. CPD is all about learning, improving, diversifying and generally providing better services and outcomes to those we look after in our profession. Evidence suggests that it improves relationships between colleagues too. What’s not to love?
It isn’t even hard to establish. Some of the key elements can be simplistically summarised as:
- Have an open discussion about what you expect to achieve.
- When observing, make brief notes, focus on positives and any areas to clarify your understanding of the reasoning process.
- When giving feedback, listen actively, be empathetic,
- reinforce the positives, avoid putting yourself as the expert. Demonstrate empathy and don’t forget to make your reflective statements as you consider what you might learn from this too.
- Share resources, experiences and evidence that may be
- helpful.
- Keep reviewing and swap roles.
- Most of all, enjoy it.
As you’d expect, reflective practice is key and we do this consciously, or otherwise, all the time. But in the world of CPD, logging and claiming points for it is something we are getting used to.
The GOC defines reflective practice as ‘...the process where you think about your experiences to gain insights about your practice and to improve the way you work or the care you give to your patients. Reflection is part of the continuous learning and development expected of you as a professional throughout your career.’
In case you missed it, Peter and Tina Arbon Black did a great CPD article (C103111) on this subject in Optician, titled 'Fundamentals of ophthalmic dispensing 29: Reflective optical practice'.'.
Interestingly, a peer could be another registered healthcare professional. For example, my better half, Sophie, is a physiotherapist, and has done observations with a range of community and hospital-based colleagues, including GPs, nurses et al. We can do the same.
I believe that, for all registrants, peer observation should become a key pillar of the CPD cycle, encouraged and enabled by employers, CPD providers and optical bodies. It would be particularly useful for those expanding their scope of practice. It is certainly something that I’m looking to champion over the next year or so, with some tools for colleagues launched after our Professional Advancement Conference (PAC) this year.
Making the leap to record your first episode of peer observation may be daunting but it is a fabulous tool, recognised by academia and in healthcare governance.
So, what’s stopping you? Maybe it is how you broach it with your colleagues, in which case here is an idea for you. I will be your catalyst, share this article with them and ask them what they think.
- Paul Morris is director of professional advancement at Specsavers UK & Ireland.